American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2014, 2(10), 225-226
DOI: 10.12691/ajmcr-2-10-7
Open AccessCase Report

Simultaneous Presentation of Metastatic Cancer and Primary Hyperparathyroidism – A Case Series

Hiang Leng Tan1, , Muhammad Imran Butt2 and Najeeb Waheed3

1Department of Diabetes and Endocrinology, Weston General Hospital, Weston-super-Mare, UK

2Department of Diabetes and Endocrinology, Peterborough City Hospital, Peterborough, UK

3Department of Diabetes and Endocrinology, Hereford County Hospital, Hereford, UK

Pub. Date: October 23, 2014

Cite this paper:
Hiang Leng Tan, Muhammad Imran Butt and Najeeb Waheed. Simultaneous Presentation of Metastatic Cancer and Primary Hyperparathyroidism – A Case Series. American Journal of Medical Case Reports. 2014; 2(10):225-226. doi: 10.12691/ajmcr-2-10-7


The objective of our two case reports is to increase awareness of the simultaneous occurrence of primary hyperparathyroidism and malignancy in patients that presents with hypercalcaemia. This report reviews the case reports from the history, investigation, treatment and outcome for these two patients. A literature review of the association between malignancy and primary hyperparathyroidism was also performed. Both patients had metastatic cancer and primary hyperparathyroidism but died within months of diagnosis despite treatment for their primary malignancy. This serves as a reminder that these two separate diagnoses do exist, though it did not alter the outcome of our patients. However, we propose that in patients with malignancy who presents with hypercalcaemia and non-suppressed PTH level, further workup should be instigated to rule out primary hyperparathyroidism as surgical option is potentially curative for the latter.

primary hyperparathyroidism metastatic cancer hypercalcaemia

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[1]  Adami S, Marcocci C, Gatti D 2002 Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res 17(Suppl 2): N18-N23
[2]  Dent CE & Watson LCA 1964 Hyperparathyroidism and cancer. British Medical Journal 2 218-221.
[3]  Palmer M, Adami HO, Krusemo UB & Ljunghall S 1988 Increased risk of malignant diseases after surgery for primary hyperparathyroidism. A nationwide cohort study. American Journal of Epidemiology 127 1031-1040.
[4]  Michels KB, Xue F, Brandt L & Ekbom A 2004 Hyperparathyroidism and subsequent incidence of breast cancer. International Journal of Cancer 110449-451.
[5]  Inga-Lena Nilsson, Jan Zedenius, Li Yin, Anders Ekbom The association between primary hyperparathyroidism and malignancy: nationwide cohort analysis on cancer incidence after parathyroidectomy. Endocr Relat Cancer. March 1, 2007, 14, 135-140.
[6]  Backlund LM, Grander D, Brandt L, Hall P & Ekbom A 2005 Parathyroid adenoma and primary CNS tumors. International Journal of Cancer 113 866-869.
[7]  Hickey RC1, Jung PJ, Merrell R, Ordonez N, Samaan NA 1991. Parathyroid adenoma in a cancer center patient population. Am J Surg. 1991 Apr; 161(4):439-42.
[8]  Fierabracci P, Pinchera A, Miccoli P, Conte PF, Vignali E, Zaccagnini M, Marcocci C & Giani C 2001 Increased prevalence of primary hyperparathyroidism in treated breast cancer. Journal of Endocrinological Investigation 24 315-320.
[9]  Sophie H A Summers, Fung Joon Foo, Sadagopan Varadarajan Hypercalcaemia in breast cancer patients: not always bony metastases BMJ Case Reports 2009.
[10]  Hypercalcaemia and treated breast cancers: the diagnostic dilemma. J Can Res Ther 2009; 5: 46-8.
[11]  Hutchesson ACJ, Bundred NJ, Ratcliffe WA. Survival in hypercalcaemic patients with cancer and co-existing primary hyperparathyroidism. Postgraduate Medical Journal. 1995; 71(831): 28-31.